HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:' `
Address: 10680 S OCEAN DR 306
Legal Description: ISLAND CREST CONDOMINIUM UNIT 306
Property Tax ID#: 4511-516-0033-000-5 Lot No.
Site Plan Name: Maryann Worsnop Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D'.ETAILED DESCRIPTIONOF WORKg
Install 1 Accordion shutter
.CONSTRUCTION INFORMATION
.v
Additional work toe e orme un er t is permit—check a appy:
HVAC Ei Gas Tank []Gas Piping Shutters []Windows/Doors
Electric 0 Plumbing []Sprinklers E Generator E] Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 2484.00 Utilities:n Sewer O Septic Building Height: 130'
' NER/LESSEE: � CONTRACTOR: "
Name Maryann Worsnop Name: Michael Heissenberg
Address:10680 S OCEAN DR 306 Company: Expert Shutter Services
City: Jensen Beach State:FIL Address: 1626 SW Biltmore St
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No.772-342-0545 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: expertpermits@aol.com
from the Owner listed above) State or County License: 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;"
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s s
_Signature of Owner/Less /Agent ySignature of on ractor/License H der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF St Lucie
The f r oing instrumAnt was acknowledged b ore me The for oing instrument was acknowledged fore me
this .day of vas 20 1�y this�ay of .s 19__ 20 IN by
Michael Heissenb&g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of ri (Signature of Notary Public-State fff F rida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification ProVNOTr'ARY
ER VIZZO Type of Identification Produced
PUBLIC ► HEATHER VIZZO
Commission No. ftad)F FLORIDA Commission No. NOTAfMEPBLIC
Vf
m#FF176266 STATE OF FLORIDA
B E 1
Revised 07/15/2014 Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS